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  • Writer's pictureVincent Tubiana

In a car accident where someone is injured, medical insurance pays, right? Think again!

Car accidents are one of those events that are unexpected and can result in serious injuries. Auto insurance is one of those things everyone has (or at least should have!), but it may not be clear how it works with injuries incurred during an accident.


A common misconception by those unfortunate enough to be in an accident is that they must use their medical insurance to pay for hospital and doctor bills. However, in Florida, it is auto insurance that is primary and must initially pay for medical bills. The coverage is called Personal Injury Protection (PIP) and is mandatory in Florida for everyone who owns a motor vehicle.  (We all have it whether we know it or not!). The good news is, this coverage is available regardless of fault. It pays up to 80% of medical bills and/or up to 60% of lost wages. One limit to consider, however, is this coverage exhausts after $10,000 has been paid.


There is a catch (of course): In order to activate these benefits, it is important that anyone who is injured in a car accident obtain medical care and treatment within 14 days from the date of the accident, and be diagnosed with an Emergency Medical Condition (EMC). In simple terms, Florida law recognizes an "EMC" as a medical condition consisting of severe pain where, if one does not seek medical attention, it could place their health in serious jeopardy.


The mistake many victims of car accidents make is waiting because they don't feel their injuries are "that-bad" or warrant immediate medical attention. To eliminate any doubt regarding qualification for PIP benefits, anyone who is involved in an automobile accident should immediately seek medical care from an urgent care facility, emergency department, primary care physician or even a chiropractor to have those injuries properly documented related to the threshold requirement of an EMC as per Florida law.


Remember, an auto insurance carrier has a duty to provide coverage, but not to be friendly or go out of their way to protect someone filing a claim with them. Of course there are exceptions, but as a rule of thumb, an insurance carrier will generally try find any legal reason NOT to pay a claim.


At the law firm of Hutchison and Tubiana, PLLC, we strive to help all who need help through this very complicated process and we know what we're doing. If you have comments or questions about this article, do not hesitate to contact me for more information.

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